Magnet and Teaching Hospitals

Do magnet and teaching hospitals generally have more do-able patient ratios than the others, or are they just like everybody else...stretching the nurse to impossible lengths? Is there really a difference in the working conditions for the nurse at these institutions?

I work at a Magnet/ Teaching hospital/ trauma I on the trauma/medsurg floor and it is just as crazy as anywhere else. We carry 6-7 pts a piece and run all night. We do have floors that are much better though like L&D, women's services, transplant.

Sep 29, '06

I was at a cardiac only for-profit non-teaching hospital, well-respected, JC accreditation w/commendation yada yada, on the floors the ratio was 10-11 pts. per RN days and nights, acuity high. CCU and RICU routinely got 3 pts. per RN. It was crazy. Many unsafe assignments IMO. I would've killed for 6-7 pts. I'd still be practicing if I could get that ratio here on Long Island. Unfortunately, not to be had. I hear the teaching hospitals in Manhattan have better ratios (6-7 pts.).

Sep 29, '06

I work in Med-Surg at a teaching hospital in Arkansas and the ratio is a maximum of 1 to 5. ICU is 1 to 2.

Sep 29, '06

I worked on a high acuity surgical unit for 2 years, during which the hospital obtained magnet status...we thought it was funny, the only change was that we had a ton more worthless "computer modules" to complete. The ratio was 4-6 patients, which I guess is not bad but we did total care nursing, no CNA's to help out- meaning that I did everything from bed baths, meds, vitals, I/O, charting,labs, walking pts, answered call lights etc....I know it took a lot of work including thousands of pages of documentation to obtain magnet status, but I really didn't see any advantage - having or not having magnet status would not ever affect my job decision....but that's just me

Sep 29, '06

I work at a magnet/teaching large metropolitan hospital and from what I can see staffing has to do with supply and demand just like at any other facility. I interviewed for 3 med/surg jobs before taking a job in ICU and was told that typically the daytime assignment would be 6-7 to 1 and the night assignment could be upwards of 8-10 to 1.

In ICU the standard is 2:1, but lately something a bit disturbing has been happening because of short staffing. There have been two instances over the past couple of weeks (during the day) when the lack of staffing threatened to create a 3:1 assignment for one of the nurses. Because the acuity of the patients was high the charge nurse wouldn't agree to assign anyone 3 patients (figuring it was unsafe).

The NM decided to allow a new orientee (just two weeks into orientation) to take an assignment by himself. Now, this particular person is very familiar with the unit and had completed two 10 week externships before graduating . . . but the reality is that he is still new as a nurse and there is a difference in taking an assignment with a preceptor at your side and taking one by yourself! He was given the lightest of the two patients on the unit (who where still complicated, on ventilators, ventriculostomies, vasopressors etc.). Fortunately in both situations a staff nurse was able to come in to oversee the new orientee for at least part of the shift.

I talked to this guy on the side about how he felt about taking an assignment so soon . . .he doesn't like it . . but doesn't feel he has any choice but to accept it.

So much for magnet status!!

Sep 29, '06

I work in a teaching hospital...we just got magnet status a few months ago. There was a huge fuss about it while we were trying for it, then when we got it, they spent a little time congratulating us, then a few months later told us that, despite the fact that we were only 2 or 3 months into the new fiscal year, we were down $6.7 million (eww, long sentence, sorry!). We are now expected to work at 103% productivity (as of last count, my unit was at 104%), cut our supply budget, etc. Some departments will be losing staff, but we won't be affected because we are variable staffing...we'll just have to work a person short "now and then". Wonderful!

Our caseload did not change at all...I work on a busy heme/onc floor with no monitors, and we have 5-6 pts each for days and eves, and 8 each for nights. We have 3 techs on days/eves and 2 on nights. We have an average census of 30-35 with a max of I believe 38. Our acuity fluctuates but is normally on the high side, sometimes very high. But, since we don't have tele (yet, they're trying to get us 8 tele beds), if someone needs frequent monitoring, you have to do it yourself. VS q15 min? Okay, then go take them by hand q15 min. Have 3 of them at the same time? Good luck doing anything else!

I've worked on the same unit for 4 years, but have some experience on a few others, and it's pretty obvious to me that the units that make money (L&D, Mother/Infant, the new Cardiac floor) get a much better deal than the rest of us. I'm not complaining about 5 pts, mind you, I know it could be a lot worse, but at the same time, I feel like they should share the wealth, you know what I mean? And I'm not talking about just for staff either. We have volunteers who bring around cookies and coffee for patients and family members, which everyone loves. In 4 years, I have seen it on my unit ONE TIME. We actually have to buy the coffee ourselves and families who want it have to pay 25 cents per cup. The patients can have instant or else have to wait for it to come up from dietary or pay for it. Is that not ridiculous???

Sorry, didn't mean to change the subject, I'm just sayin' that I don't think that magnet status really means anything!

Sep 29, '06

Wow, reading these posts really make me see how lucky I am! I work at a Not for profit hospital in VA on the Medical Care Unit as a CNA and the nurses there have 4-6 pts on night shift and I usually 10-20pts depending on census and whether or not there's another CNA there. Even when I have a full patient load it's not bad because we all work as a team to get things done, I love it there.